It has been three years since ACDIS last surveyed its membership about physician query practices. In 2010, 382 CDI professionals participated. This year’s survey garnered 517 respondents, primarily CDI specialists.
“That’s really a tremendous response rate,” says Drew K. Siegel,...Read More »
Auditors have been reviewing medical necessity for inpatient services for years and Recovery Auditors (RA) have recouped millions of dollars in overpayments. Now outpatient providers are beginning to see more and more medical necessity audits, especially in the ED and for evaluation and...Read More »
CDI specialists should review the overall quality of medical record documentation from the day a patient comes into the ER—regardless of whether that patient ultimately ends up in observation, as an inpatient, or elsewhere.
“Quality of care is not segregated into buckets,” says Glenn...Read More »
Q:Our CDI program is three years old and our administration still questions our productivity goals. Initially we set benchmarks at 90-95% coverage rate of Medicare/Managed Medicare; 20-25% query rate; 90% response rate and 80% agree rate. Since census varies, we also...Read More »
Many CDI managers use case-mix index (CMI) as the primary metric for determining the success or failure of their program. If the CMI rises in a given month, the CDI staff is doing its job, appropriately querying physicians for the correct principal diagnosis and...Read More »
Q: For a newly trained CDI specialist, what is the approximate number of reviews (both concurrent and follow up) one should expect him/her to be able to handle per day? I recall from the CDI Boot Camp that the starting number was about 10, but I can’t remember how many new versus follow-...Read More »
If you have experience with the topic below, please email Linnea Archibald at larchibald@acdis.org by noon eastern on Friday, August 18, and she'll connect you with the relevant folks at the end of the day on...Read More »